Inclement Weather Overflow Volunteer Application

I am currently 21 years of age or older.

YesNo

I have access to my own, reliable transportation.

YesNo

I have a cellphone I can use for communication purposes.

YesNo

Candidate Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

example@example.com

Phone Number*

Area CodePhone Number

Date of Birth*

Date

Emergency Contact*

	Name	Phone Number	Relationship
Contact

Why are you interested in becoming a volunteer?*

What are your previous volunteering experiences?*

Have you worked with individuals experiencing homelessness previously?

YesNo

What types of volunteer activities are you interested in? Please select all that apply.

Staffing a temporary shelterCooking food for sheltering individualsDoing laundry the next daySite set-up (getting cots, bedding, food to a location)Site break-down (cleaning up shelter sites)

What days and hours are you available to volunteer?

Inclement Weather Sheltering Training Dates:

Saturday, 11/22 10am-noon at Summit LeadershipMonday, 11/24 5-7pm at Summit LeadershipNone of these work for me, but let me know of upcoming events!

Where did you hear about us?*

Privacy Statement: The personal information above is collected in order to evaluate the volunteer candidates during the evaluation process. The information may be shared with program and organization partners.

By volunteering for the Inclement Weather Sheltering program, you acknowledge and accept the following:

Personal Responsibility: You are solely responsible for your own safety and well-being while participating in this program. This includes, but is not limited to, your actions, decisions, and interactions with other volunteers and shelter guests. You understand that you are volunteering in an environment involving individuals experiencing homelessness and that inherent risks exist.
Inclement Weather Conditions: You understand that volunteering involves exposure to potentially hazardous weather conditions (temperatures of 35°F or lower). You are responsible for dressing appropriately and taking necessary precautions to protect your health and safety while traveling and at the shelter site.
No Guarantee of Participation: This form does not guarantee your participation in inclement weather sheltering. The program reserves the right to accept or decline volunteers based on program needs and capacity. Assignment to specific shifts or roles is not guaranteed and is at the discretion of the program organizers.
Assumption of Risk: You voluntarily assume all risks associated with participating in this program, including but not limited to the risk of injury, illness, or exposure to communicable diseases.
Release of Liability: To the fullest extent permitted by law, you release the Inclement Weather Sheltering program, its organizers, volunteers, and affiliates from any and all liability for injury, loss, or damage, whether direct or indirect, arising from your participation in this program.

This disclaimer is not exhaustive, and other risks may exist. By volunteering, you acknowledge that you have read, understood, and agree to the terms and conditions stated herein. By signing this, I acknowledge that the information I've given is accurate.

Candidate Signature*

Inclement Weather Overflow Volunteer Application

Volunteer training